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July 8, 2009
Volume IX, Number 14
IN THIS ISSUE
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State Legislation, Policy & Reports
Iowa: New Quality Assurance Fee Will Boost Direct-Care Staff
Compensation More...
Montana: State Deploys ARRA Funds for Long-Term Care and Senior
Services More...
Tennessee: The Adult Care Homes Act Becomes Law More...
Policy Brief Shines Light on Paid Family Leave Programs More...
Federal Legislation, Policy & Reports
Senators Introduce Home and Community Balanced Incentives Act of 2009
More...
Senior Navigation and Planning Act of 2009 Focuses on End-of-Life
Decisions More...
Medicare Nursing Home Guidance Aims to Improve Residents' Quality of
Life More...
International News
World: With Older Population Likely to Triple by 2050, Global Aging Is
"A Slow Burning Fuse" More...
Research Reports & Journal Articles
Pew Survey Reveals View of Growing Old Depends on Age More...
Study Shows Nurse Care Managers Can Help Dementia Caregivers More...
A New Patient Care Model Assesses If Elderly Can Live Alone More...
Conferences & Trainings
10th International Conference on Alzheimer's Drug Discovery, September
14-15 More...
2nd UCLA Technology & Aging Conference, October 30 More...
Funding, Media & Miscellaneous
Hawaii Seeks Proposals for Long-Term Care Commission Policy Research
More...
PHI Launches PolicyWorks to Strengthen Direct-Care Workforce More...
NPR Maps Dementia-Driven Wandering More...
U.S. in Need of a "Reality Road Test on Independence" Says Ellen
Goodman More...
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State Legislation, Policy & Reports
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Iowa: New Quality Assurance Fee Will Boost Direct-Care Staff
Compensation
Governor Chet Culver, at the end of May, signed into law Senate File
476 to implement a fund leveraging strategy for Iowa's long-term care
delivery system. All for-profit and nonprofit nursing facilities now
must pay a quality assurance fee of 3 percent per patient day.
Annually, this "granny tax" is expected to generate about $33 million
that will be deposited in a state-run Quality Assurance Trust Fund and
used to leverage $45 million or more in federal Medicaid matching
funds. According to PHI, an advocacy group for the direct-care
workforce, at least 35 percent of the new revenue must be used to
increase compensation for direct-care workers, such as certified
nurse's aides. Most facilities will see a net revenue gain, but those
with a low share of Medicaid bed days will have a net loss. For more
information, visit:
Iowa General Assembly
PHI
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Montana: State Deploys ARRA Funds to Support Long-Term Care and Senior
Services
The Montana Department of Public Health and Human Services (DPHHS)
reports the American Recovery and Reinvestment Act will increase wages
for Montana's direct-care and ancillary service staff in long-term
care. The Legislature, through the Montana Reinvestment Act (H.R.
645), appropriated $16. 3 million, including $4.5 million general
funds, to raise provider rates to fund a one-time direct-care worker
wage increase for Medicaid services in the Senior and Long Term Care
Division. The rate increase, for the 2011 biennium only, goes to
nursing facility providers, personal assistance providers and other
community-based service providers. The Legislature also designated $3
million for non-Medicaid community aging services through contracts
with the Area Agencies on Aging for transportation, congregate meals
and meals on wheels, respite care, home chore services, legal
assistance, long term care ombudsman and information and referral
services. For more information, visit:
Montana DPHHS
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Tennessee: The Adult Care Homes Act Becomes Law
During the 2009 legislative session, state lawmakers unanimously
approved The Adult Care Homes Act (SR 2275/HB 2282), creating a new
housing option for Tennesseans who receive long-term care services but
don't want to live in large nursing homes. Governor Phil Bredesen
signed the bill into law on July 1, authorizing licensure of small
residences operated for two to five people. Originally the bill would
have allowed caregivers to operate adult care homes for anyone who
receives long-term care services, but lawmakers decided to limit the
new option to ventilator-dependent and brain-damaged Tennesseans.
According to Clarksville Online, Senator Lowe Finney and other
sponsors of the bill vow to take up legislation in 2010 so those who
need less care also may live in adult care homes. For more
information, visit:
Tennessee Legislature
Clarkesville Online
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Policy Brief Shines Light on Paid Family Leave Programs
In June, Boston College Graduate School of Social Work's Sloan Work
and Family Research Network released "Paid Family Leave: One Solution
to Helping Today's Working Families Meet Their Family Responsibilities
at Critical Times." Prepared by Julie Weber, J.D., with support from
the Alfred P. Sloan Foundation, this brief gives state legislators and
other state policy makers a quick review of paid family leave (PFL),
including its importance, why the federal Family and Medical Leave Act
is insufficient and what's happening at the state level. It compares
three states' PFL laws (California, New Jersey and Washington),
looking at compensation, length of benefit, structure and funding.
For more information and to download the four-page brief, visit:
Work and Family Research Network
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Federal Legislation, Policy & Reports
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Senators Introduce Home and Community Balanced Incentives Act of 2009
On June 11, Senators Maria Cantwell (D-WA) and Herbert Kohl (D-WI)
introduced the Home and Community Balanced Incentives Act of 2009 (S.
1256). This bill would amend Title XIX of the Social Security Act to
enhance Medicaid matching rates for States to expand home and
community-based long-term care and services for Medicaid
beneficiaries. Among the bill's provisions are improving case
management to help people stay out of nursing homes, allowing for
consumer direction, developing a services and information
clearinghouse to help people easily learn about their home and
community-based options, creating a standardized method for tracking
home and community-based services, and collecting data on consumer
outcomes. For more information, visit:
Thomas
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Senior Navigation and Planning Act of 2009 Focuses on End-of-Life
Decisions
Senator Mark Warner (D-VA) introduced the Senior Navigation and
Planning Act of 2009 in mid June (as S. 1251 and S. 1263) to
strengthen counseling, support services and care management for
patients and families coping with life-limiting illnesses. "This
legislation will not deny health care to patients and families that
want it," Senator Warner said. "But I firmly believe that any
comprehensive health reform should include more information,
counseling and resources that will allow patients, their families,
their caregivers and others to consider and discuss decisions about
when and how long to pursue treatments at the end of life." Without
access to such planning assistance, the result for patients nearing
the end of life may be unnecessary tests, treatments and
hospitalizations that more informed individuals might not choose. For
more information, visit:
Thomas
Sen. Mark Warner
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Medicare Nursing Home Guidance Aims to Improve Residents' Quality of
Life
On June 19, the Centers for Medicare & Medicaid Services (CMS) issued
new guidance for nursing home surveyors to sharpen focus on key
dimensions of care. According to CMS Acting Administrator Charlene
Frizzera, the revisions are "intended to support efforts underway to
transform nursing homes into environments that are more like
[residents'] homes through both environmental changes and resident-
centered caregiving." Surveyors are asked to look at how nursing homes
ensure residents live with dignity, offer choices in care and
services, accommodate the environment to each resident's needs and
preferences, and create a more homelike environment. For more
information, and to download the guidance, visit:
CMS
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International News
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World: With Older Population Likely to Triple by 2050, Global Aging Is
"A Slow Burning Fuse"
The U.S. Census Bureau announced on June 23 that the world's 65-and-
older population will probably triple by mid-century, from 516 million
in 2009 to 1.53 billion in 2050. During the same period, the under-15
population likely will grow by just 6 percent (from 1.83 billion to
1.93 billion). This latest update from the Census Bureau's
International Data Base includes projections by age, including people
100 and older, for 227 countries and areas. A special report from
Economist.com on June 25, "A Slow Burning Fuse," written by Barbara
Beck, takes a look at the reasons why the world is getting so much
older. In the 1970s women across the world gave birth to an average of
4.3 children each, compared to 2.6 globally today and just 1.6 in rich
countries. The economic, social and political consequences of this
"slow-
moving but relentless development," she says, are "scary." For more
information, visit:
US Census Bureau
Economist.com
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Research Reports & Journal Articles
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Pew Survey Reveals View of Growing Old Depends on Age
A Pew Research Center survey on Social & Demographic Trends queried a
nationally representative sample of 2,969 adults. "Growing Old in
America: Expectations vs. Reality," released June 29, finds "Growing
old isn't nearly as bad as people think it will be. Nor is it quite as
good." When does old age begin? Those between the ages of 18 and 29
said 60, middle-aged respondents put the age nearer 70 and those older
than 65 said the average person does not become old before 74. All
generations agreed on a handful of markers for old age: failing
health, an inability to live independently or drive, and difficulty
with stairs. The best thing, by far, about getting old, according to
older adults, is being able to spend more time with family members.
Three-fourths of adults with a parent over the age of 65 are very
satisfied with the relationship with their parent/s; if a parent needs
help caring for his or her needs, that share falls to 62 percent. For
more information and to download the 151-page report, visit:
Pew Research Center
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Study Shows Nurse Care Managers Can Help Dementia Caregivers
An article in the June/July 2009 issue of American Journal of
Alzheimer's Disease and Other Dementias, 24 (3), by Janet Specht and
four colleagues from the University of Iowa College of Nursing, points
to the effectiveness of assistance from nurse care managers in
supporting caregivers of persons with dementia who live at home.
Caregivers who received assistance were more likely to show
improvement, consistent over time, in their stress levels, endurance
potential and well-being. The article, "The Effects of a Dementia
Nurse Care Manager on Improving Caregiver Outcomes," defines the role
of dementia nurse care management and shares the results of the
outcomes measurements. For more information, visit:
American Journal of Alzheimer's Disease
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A New Patient Care Model Assesses Elder's Ability to Live Alone
Researchers at Baylor College of Medicine and the Michael E. DeBakey
Veterans Affairs Medical Center at Houston report they have developed
a systematic, interdisciplinary approach to "capacity assessment and
intervention" (CAI) for older adults. An Archives of Gerontology and
Geriatrics article in press, "Determining If an Older Adult Can Make
and Execute Decisions to Live Safely at Home: A Capacity Assessment
and Intervention Model," by fourth-year medical student Felicia
Skelton and three colleagues, follows one patient through the CAI
process and examines two other cases to highlight challenges in
capacity assessment. For more information, visit:
Archives of Gerontology and Geriatrics
Baylor College of Medicine
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Conferences & Trainings
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10th International Conference on Alzheimer's Drug Discovery, September
14-15
The Alzheimer's Drug Discovery Foundation (ADDF) presents the 10th
International Conference on Alzheimer's Disease Drug Discovery on
September 14 and 15 in Jersey City, NJ. ADDF is a public charity
dedicated to accelerating the discovery and development of drugs to
prevent, treat and cure Alzheimer's disease and cognitive aging. This
conference brings together academic and industry scientists for that
purpose. For more information and to register, visit:
ADDF
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2nd UCLA Technology & Aging Conference, October 30
At this one-day conference academic and industry leaders will discuss
how the latest technologies in the medical, consumer and lifestyle
fields will help older adults live better, longer lives. Its breakout
sessions address two themes: Aging In Place and Aging Healthier
Longer. The conference will be held at the Skirball Cultural Center in
Los Angeles. For more information and to register, visit:
UCLA Center on Aging
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Funding, Media & Miscellaneous
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Hawaii Seeks Proposals for Long-Term Care Commission Policy Research
The University of Hawaii at Manoa's Social Sciences Public Policy
Center (SSPPC) has issued a Request for Proposal, "Assessing Long Term
Care and Policy Options for the State of Hawaii." They are seeking a
researcher to undertake and to coordinate research to execute a work
plan developed by the State of Hawaii Long-Term Care Commission
(LTCC). Act 224, Session Laws of Hawaii 2008, established the LTCC to
do a two-year comprehensive assessment of the long-care needs of the
population, assess the adequacy and challenges of the current long-
term care infrastructure, and recommend measures and policies to
create a financing system and services structure that meets the future
needs of the aging population. Deadline for proposals is July 20. For
more information, visit:
Public Policy Center
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PHI Launches PolicyWorks to Strengthen Direct-Care Workforce
In June, PHI announced that PolicyWorks, an online strategy center, is
up and running to promote national and state policy solutions for the
direct-care workforce. Features of the center include Strategic Areas,
which provides frameworks for understanding leading policy issues;
Workforce Facts, which focuses on the demographics, size and economic
impact of the direct-care workforce; Policy Recommendations; a Chart
Gallery of key data; a Guide to Accessing Federal Recovery Act Funds;
and Health Reform Resource Center, which aims to make sure national
change efforts work for direct-care workers.
PolicyWorks
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NPR Maps Dementia-Driven Wandering
National Public Radio's Linton Weeks told the stories of three Maine
wanderers with dementia in his June 29 program, "The Mysteries of
Dementia-Driven Wandering." Their trips had three different outcomes:
safe return, disappearance and death. Mr. Weeks explored the impetus
to wander from both cultural and medical perspectives and offered
strategies for managing wandering behavior, tapping advice from Robert
Koester, who wrote Lost Person Behavior and is the former president of
the Virginia Search and Rescue Council. Covered in this program, too,
were special devices, such as shoes with GPS technology for wanderers
to wear, the MedicAlert+Safe Return initiative of the Alzheimer's
Association and states' Silver Alert emergency program to find missing
seniors. For more information, visit:
NPR
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U.S. in Need of a "Reality Road Test on Independence" Says Ellen
Goodman
Nationally syndicated columnist Ellen Goodman wished her readers
"Happy Dependence Day" on July 3. "About 34 million Americans provide
at least some of the care for frail, aging family members and yet we
don't see it as a normal, predictable part of the life cycle," she
writes. She refers to Paula Span's book, When the Time Comes, as a
welcome "support group in print." Despite 40 books on pregnancy and
childbirth, no best-seller exists entitled "What to Expect When They
are Declining" or any "Missing Manual" on "what to do when our parents
become too frail or confused to live alone." American child-rearing
seems to leave out "the lesson that caregiving continues through the
life cycle," she says. "Needing help is not role reversal but joint
responsibility." For more information, visit:
Boston Globe
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